Holy Cross Workers Catch a Ne ...

Fifteen hundred workers at Holy Cross Hospital made health insurance decisions in November, with their choices to take effect Jan. 1. Ninety percent sought coverage under the hospital's in-house insurance network, with the others selecting the only alternative, Kaiser Permanente's HMO plan.

But something went wrong in the computerized registration process at the Silver Spring hospital, as some of those Kaiser members learned after Jan. 1. It was not a pleasant surprise, said Mary Clark, a nurse at the hospital since 1979.

"I've been at this since January 2," she said five days later, "trying to get . . . ID cards" for herself, her husband and two children who attend college out of town. Clark said she went to the Kaiser clinic in Silver Spring on Jan. 6. "They were very nice and tried to work with the problem," she said, but without the membership cards or identification numbers that should have been issued, Clark was on her own. "I had to pay cash out for my pain medication," she said, about $65 in all.

The problem also troubled her husband. "I can't go to the doctor to get my prescriptions refilled," said Tom Clark, who has congestive heart failure, chronic obstructive pulmonary disease and sleep apnea, which requires him to breathe through a tube in his trachea. "I need medical attention in the morning," he said on Jan. 8. Without coverage from Kaiser, "I'm probably going to shell out $1,000 real quick. I don't have that kind of money."

Eileen Cahill, a spokeswoman for Holy Cross, blamed the problem on "a Web interface issue." In addition to moving from a midyear enrollment period to a year-end schedule, she said, "we did convert from filing paperwork" to having workers register via computer. Of the 150 or so workers who selected Kaiser, she said last week, Holy Cross "had reports of 10 employees where there was a known electronic glitch."

"In January, because of the volume of people" who change insurers, "you're more likely to run into some glitches, said Susan Whyte Simon, a Kaiser spokeswoman. "Every so often, someone's name is inadvertently not on a list."

Fewer than five Holy Cross employees had contacted the insurer about faulty registration, but "they are all enrolled in our system," Simon said on Jan. 9. She added that Kaiser was assigning staffers to ensure that those affected had membership cards or temporary registration numbers. Simon also said people who paid directly for care or drugs would be eligible for reimbursements.

While the affected workers may have felt they were in insurance limbo, Simon said none of them needed extensive care in the initial days of the year -- and if they had, "between us and Holy Cross, we would have taken care of them."

All's well that ends well? Yes and no.

"We got word this morning" that Kaiser was honoring her membership, Clark said on Jan. 9, but the snafu left her sounding more like a victim of health care's foibles than one of its providers: "You're supposed to be this wonderful hospital for the community, but what are you doing for the employees?"

-- Tom Graham

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